Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
Ophthalmology. 2013 Dec;120(12):2476-2484. doi: 10.1016/j.ophtha.2013.07.020. Epub 2013 Aug 30.
To determine the extent of difference between better-eye visual field (VF) mean deviation (MD) and integrated VF (IVF) MD among Salisbury Eye Evaluation (SEE) subjects and a larger group of glaucoma clinic subjects and to assess how those measures relate to objective and subjective measures of ability/performance in SEE subjects.
Retrospective analysis of population- and clinic-based samples of adults.
A total of 490 SEE and 7053 glaucoma clinic subjects with VF loss (MD ≤-3 decibels [dB] in at least 1 eye).
Visual field testing was performed in each eye, and IVF MD was calculated. Differences between better-eye and IVF MD were calculated for SEE and clinic-based subjects. In SEE subjects with VF loss, models were constructed to compare the relative impact of better-eye and IVF MD on driving habits, mobility, self-reported vision-related function, and reading speed.
Difference between better-eye and IVF MD and relationship of better-eye and IVF MD with performance measures.
The median difference between better-eye and IVF MD was 0.41 dB (interquartile range [IQR], -0.21 to 1.04 dB) and 0.72 dB (IQR, 0.04-1.45 dB) for SEE subjects and clinic-based patients with glaucoma, respectively, with differences of ≥ 2 dB between the 2 MDs observed in 9% and 18% of the groups, respectively. Among SEE subjects with VF loss, both MDs demonstrated similar associations with multiple ability and performance metrics as judged by the presence/absence of a statistically significant association between the MD and the metric, the magnitude of observed associations (odds ratios, rate ratios, or regression coefficients associated with 5-dB decrements in MD), and the extent of variability in the metric explained by the model (R(2)). Similar associations of similar magnitude also were noted for the subgroup of subjects with glaucoma and subjects in whom better-eye and IVF MD differed by ≥ 2 dB.
The IVF MD rarely differs from better-eye MD, and similar associations between VF loss and visual disability are obtained using either MD. Unlike better-eye MD, IVF measurements require extra software/calculation. As such, information from studies using better-eye MD can be more easily integrated into clinical decision-making, making better-eye MD a robust and meaningful method for reporting VF loss severity.
确定 Salisbury 眼评估（SEE）受试者和更大的青光眼临床受试者群体中较好眼视野（VF）平均偏差（MD）和综合 VF（IVF）MD 之间的差异程度，并评估这些测量值与 SEE 受试者的客观和主观能力/表现测量值之间的关系。
基于人群和基于诊所的成年人样本的回顾性分析。
共纳入 490 名 SEE 和 7053 名 VF 丧失（至少 1 只眼 MD≤-3 分贝[dB]）的青光眼临床受试者。
对每只眼进行视野测试，并计算 IVF MD。计算 SEE 和基于诊所的受试者较好眼和 IVF MD 之间的差异。在 VF 丧失的 SEE 受试者中，构建模型比较较好眼和 IVF MD 对驾驶习惯、活动能力、自我报告的视力相关功能和阅读速度的相对影响。
较好眼和 IVF MD 之间的差异以及较好眼和 IVF MD 与表现测量值的关系。
SEE 受试者和青光眼临床受试者的较好眼和 IVF MD 之间的中位数差异分别为 0.41 dB（四分位距[IQR]，-0.21 至 1.04 dB）和 0.72 dB（IQR，0.04 至 1.45 dB），2 种 MD 之间的差异≥2 dB 的情况分别占 9%和 18%。在 VF 丧失的 SEE 受试者中，MD 与多种能力和表现指标之间的关联均相似，判断标准为 MD 与指标之间是否存在统计学显著关联、观察到的关联程度（与 MD 下降 5 dB 相关的优势比、率比或回归系数）以及模型解释指标的变异性程度（R²）。对于青光眼亚组和较好眼和 IVF MD 差异≥2 dB 的受试者亚组，也观察到类似的关联，其关联程度相似。
IVF MD 很少与较好眼 MD 不同，并且使用任一 MD 都可以获得 VF 丧失与视觉障碍之间的类似关联。与较好眼 MD 不同，IVF 测量需要额外的软件/计算。因此，使用较好眼 MD 的研究信息可以更轻松地整合到临床决策中，使较好眼 MD 成为报告 VF 丧失严重程度的一种可靠且有意义的方法。
